Hysteria

September 14, 2011

Few topics in the world of psychoanalysis are as controversial as hysteria. There is no current consensus on whether or not hysteria exists today or whether or not it ever existed at any time at all. Explaining exactly what hysteria is and what it means has challenged and baffled many generations of physicians.

As an illness, hysteria has been associated with women even though male sufferers were at one time identified and discussed. It is commonly assumed that Hippocrates first used hysteria as a general descriptive term for the aliments of the womb. The word hysteria itself is derived from the Greek word for the uterus. There is also evidence that an identifiably corresponding disease is mentioned in ancient Egyptian manuscripts that predate the general Greek term by at least several centuries.

The problem with trying to apply hysteria in historical and cultural contexts is that the term refers to both an illness characterized by strange symptoms as well as to certain disturbing forms of behavior. Only as recently as 100 years ago it was thought that the physiological basis for female insanity existed in the reproductive organs. This may help explain why the ailment was said to cause the womb to “wander.” But whether it was a malady or maladjustment, hysteria primarily involved the manifestation of many interchangeable outward symptoms without any tangible physical cause. It was a disease that made the victim appear irrational, untrustworthy, and difficult to control.

These are some of the reasons hysteria was also employed as a psychiatric label for the witchcraft writings of the 19th century. The label was applied to the historical findings of hysterical sensory disturbances, which were considered proof of witchcraft up until the 17th century. However, these “witches” were not seen as “hysterics” by their contemporaries. They were seen as willing servants of Satan, who deserved the harshest treatment and the most painful death imaginable.

During the 19th century a debate arose as to whether the illness was composed of symptoms or behaviors. Within the proper Victorian hierarchal view of the world, the hysteric came to embody femininity itself, both as a problem and an enigma. Modern historical analysis of Sigmund Freud’s psychoanalytic approach has revealed a new view of this unique psychosomatic condition that hysteria was less of a clinical puzzle to be solved than a response to political intervention. Hysteria can be seen as a physical expression of a profound sense of discomfort when women tried to reach beyond their tolerable societal limits.

In modern times hysteria has virtually disappeared from our theoretical literature, diagnostic manuals, and training programs. The modern clinical symptoms of the disease are apt to be “mixed” forms where the illness is interspersed with other neurotic disturbances. The actual physical symptoms differ very little from those described in the 19th century. They range from complete paralysis to tremors, tics, amnesia, loss of speech or hearing, nausea, vomiting, and dramatic fits.